NPIMap

Organization Active NPI

Sandra J. Bennett, DMD LLC

  • Dental Clinic/Center
  • Gresham, OR
National Provider Identifier
1053586529
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SANDRA J. BENNETT, DMD LLC
Practice address
22400 SE Stark St
Gresham, OR 97030-2656
Phone
(503) 667-0438
Fax
(503) 665-4870
NPI assigned
Apr 25, 2008
Last updated
Apr 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sandra J. Bennett, DMDNPI 1932157609
Title
Owner
Phone
(503) 667-0438

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

22400 SE Stark St
Gresham, OR 97030-2656

Mailing address

22400 SE Stark St
Gresham, OR 97030-2656
Phone (503) 667-0438

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1053586529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22400 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302656",
            "telephone_number": "503-667-0438",
            "fax_number": "503-665-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22400 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302656",
            "telephone_number": "503-667-0438",
            "fax_number": "503-665-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA J. BENNETT, DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-667-0438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.